CREW (Cardiac Rehabilitation Especially for Women) is a specific care pathway program developed by the Flinders University-led CHAP Project (Country Heart Attack Prevention) and tested through a study to determine whether the program can be successfully delivered, adopted and accepted by women with cardiovascular disease, and also by cardiac rehabilitation clinicians in rural and remote communities.
“The lack of women-focused programs are major barriers,” says Flinders University researcher Dr Joyce Ramos, “but home-based cardiac rehabilitation using telehealth and gender-tailored approaches may help address these challenges.
The study involved 40 women in rural or remote South Australia who were referred to cardiac rehabilitation through the integrated Cardiovascular Clinical Network (iCCNet) between November 2023 and November 2024. They were invited to use the CREW program, which included four educational modules designed to support self-management, and their completion rates were assessed using digital records.
The participants recorded high rates of cardiac rehabilitation initiation (82.5%) and completion (60%), and the participants also reported high satisfaction with most program components.
“These findings highlighted the value of a women-focused approach to support women engage with their heart health,” says Dr Ramos. “They should also increase clinician awareness about the importance of recognising and addressing women's unique needs throughout the cardiac rehabilitation journey.”
Interviews conducted with the CREW participants and clinicians delivering cardiac rehabilitation explored the CREW program’s feasibility, acceptability and perceived value.
This analysis identified several themes that underlined the CREW program’s strengths: it empowers women in cardiac rehabilitation; it reinforces the value of telehealth-based cardiac rehabilitation for women's participation; and it addresses challenges and resource pressures facing health staff and systems. It also offered recommendations for program enhancement.
“The CREW program is feasible and acceptable to women and clinicians, which shows that this women-focused, web-based model shows promise for addressing gender disparities in cardiac rehabilitation access in rural and remote communities.”
The research – “Feasibility and Acceptability of the Cardiac Rehabilitation Especially for Women (CREW) Web-Based Program in Rural and Remote Communities: A Mixed-Method Study”, by Orathai Suebkinorn, Alline Beleigoli, Robyn Clark, Lemlem Gebremichael, Norma Bulamu, Jeroen Hendriks, Jonathon Foote, Anita Lymn, Sherry Grace and Joyce Ramos, being the Cardiac Rehabilitation Especially for Women (CREW) Project Team – has been published in Heart, Lung and Circulation . DOI: 10.1016/j.hlc.2026.06.021
Observational study
People
Feasibility and Acceptability of the Cardiac Rehabilitation Especially for Women (CREW) Web-Based Program in Rural and Remote Communities: A Mixed-Method Study
3-Aug-2026